DIABETES-INSIPIDUS IN PREGNANCY - A TREATABLE CAUSE OF OLIGOHYDRAMNIOS

Background: Diabetes insipidus, which presents with polyuria, polydips ia, and profound electrolyte abnormalities, occurs rarely in pregnancy . We report a patient with severe oligohydramnios that resolved after treatment of diabetes insipidus. Case: A 14-year-old girl was admitted at 33 weeks' gestation with cramping and vaginal spotting. A sonogram indicated oligohydramnios and an amniotic fluid index (AFI) of 2.6, w ith normal fetal kidneys and bladder. On hospital day 2, the AFI was 0 .0. Recorded fluid was 8 L in and 13.6 L out. Serum sodium was 153 mEq /L. Diabetes insipidus was diagnosed and treated with intranasal desmo pressin acetate. The oligohydramnios resolved rapidly, and the patient delivered a healthy 2700-g male infant at 38 weeks. Conclusion: Altho ugh rare, diabetes insipidus may present initially in pregnancy and sh ould be considered in patients with oligohydramnios. Simple diagnosis with determination of 24-hour urine volume and serum electrolytes can identify this potentially reversible cause of oligohydramnios and poor obstetric outcome. (C) 1997 by The American College of Obstetricians and Gynecologists.